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What is rectal prolapse?

Rectal prolapse is seen at all ages but appears to have a higher incidence between the ages of 40 and 70 years. It also seems to occur 80% of the time in women. Risk factors for developing rectal prolapse include increased rectal motility, chronic straining and pelvic floor weakness due to childbirth.

What are the signs and symptoms of rectal prolapse?

The symptoms of rectal prolapse include:

  • feeling of bulge in the anus
  • rectal bleeding
  • mucus discharge
  • incomplete evacuation
  • fecal incontinence (35-80%)
  • constipation (50%)

The signs of rectal prolapse include:

  • prolapse
  • perineal dissent
  • patulous anus
  • solitary rectal ulcer

How is rectal prolapse investigated?

Rectal prolapse can be confused with hemorrhoidal prolapse as they present in a similar way. Your colorectal specialist will evaluate you in the office to determine if you have rectal prolapse or hemorrhoidal prolapse. In addition, your doctor may also include additional tests in evaluating you such as:

  • colonoscopy
  • anorectal physiology
  • x-ray defacography
  • colonic transit study

How is rectal prolapse treated?

Rectal prolapse can be managed with non-surgical options such as pelvic floor rehabilitation primarily if the prolapse is partial (intussusception).

There are a number of surgical procedures available to treat rectal prolapse. The surgeries include the following:

  • laparoscopic or robotic rectopexy
  • laparoscopic or robotic sigmoid resection and rectopexy
  • perineal proctectomy

Your surgeon will examine you and based on the type of rectal prolapse you have and the symptoms you have, will offer you a surgical option appropriate for your condition.